老年人内在能力的研究现状

随着年龄增长,人体组织和器官功能减退,老年人的躯体功能也逐渐下降,部分老年人出现日常生活活动能力下降甚至完全失能。为此,世界卫生组织提出健康老龄化概念,打破传统的疾病诊疗观念,转向维护老年人的功能状态,特别是内在能力状态。本文针对内在能力的概念,内在能力与衰弱、躯体复原力的关系,以及内在能力对老年人不良健康结局的影响进行综述,以期为社区高龄衰弱老年人开展更恰当的内在能力筛查、评估与干预提供参考依据,支持老年人居家生活自立。     

老年人长期照护需求及影响因素

<正>在养老服务体系建设过程中,发现缺乏基本的养老需求信息〔1〕。Lindeman等〔2〕分析了澳大利亚老年人对社区照顾服务的需求。Tamaki等〔3〕研究了日本家庭对社区照顾的需要。本研究旨在调查南京市某社区老年人的长期照护需求,分析影响因素。1对象与方法1.1研究对象用方便抽样的方法选取南京市秦淮区、鼓楼区、江宁区的老年人279名,入选标准:年龄>60岁、无语言交流障碍、神志清醒、无认知障碍且知情同意者。年龄60~92〔平     

国外老年人照护者分类研究进展与启示

目前,世界正面临着前所未有的老年人口的增加〔1〕,与人口老龄化同步的依赖性照护亦在增长〔2〕。在人生的最后阶段,大量的老人需要其他人提供各种各样的帮助,照护者的支持性帮助是为虚弱老人提供照护的关键〔3〕。照护者从服务内容、场所和是否有偿方面可分为正式照护者和非正式照护者。人口老龄化引发的相关问题和公共支出的压力使得非正式照护成     

城市老年人长期照护需求分析

目的探讨城市老年人照护需求的现状。方法运用美国老年人资源和服务操作功能评价量表(OARS)对淮安市200名老年人进行问卷调查。结果城市老年人存在一定程度的照护需求,不同性别城市老年人的照护需求不存在显著性差异(P>0.05),而不同年龄、婚姻状况、教育水平、养老方式的城市老年人的照护需求存在显著性差异(P<0.05)。结论了解不同特征城市老年人的照护需求,为老年人提供全方位而有针对性的照护服务。     

失能老年人机构长期照护需求及影响因素

目的了解重庆市失能老年人机构长期照护需求及影响因素。方法基于日常生活能力(ADL)量表对机构照护的老年人进行失能判定,并设计机构长期照护需求调查表进行问卷调研。结果重庆市机构照护的失能老年人对日常生活必需且服务频次多的项目需求率较高,影响照护需求最为显著的因素是失能程度、失能时间及月收入。结论重庆市长期照护服务内容制定应首先解决需求率较高的照护项目。     

国外居家失能老年人主要照护者照护负担干预研究进展

<正>目前,世界已进入一个老龄化的时代,联合国人口署预测,到2050年,80岁及以上人口比例将增高4倍〔1〕,65岁以上的世界人口将从7.6%上升到16.2%,即增加10亿老龄人口〔2〕。随着老龄化人口快速的增长,与之相适应的依赖性照护也在增长〔3〕。家庭是老年人安享晚年的最佳地方,当老年人生理机能下降,逐渐出现功能性依赖,这就需要家庭成员给予相应的照护。因此居家照护作为传统的照护模式被许多国家失能老年     

老年人内在能力评估工具的研究进展

为了更好应对人口老龄化问题,世界卫生组织2015年提出了内在能力这个新概念模型,旨在更加关注老年人的功能状态,成为老年医学研究的新方向。早期筛查和评估内在能力对老年人来说至关重要。然而,到目前为止,对内在能力的评估尚未达成共识。本文就目前关于内在能力评估工具进行综述,以期为临床的医护人员评估内在能力提供参考依据。     

维吾尔族、哈萨克族失能老年人居家主要照护者照护负担及影响因素

目的探讨维吾尔族、哈萨克族失能老年人居家主要照护者照护负担及影响因素。方法应用ZBI照护负担量表对621例维吾尔族、哈萨克族失能老年人的主要照护者进行照护负担研究。结果维吾尔族、哈萨克族居家照护者照护负担平均得分为(20.04±8.551)分,有50.1%的照护者存在不同程度的照护负担;多元线性回归分析显示:老年人失能程度、认知情况、现居住地、子女经济收入、照护老人花费、照护者与被照护者关系、有无其他人员参与照护、有无照护能力、有无社区机构提供正式帮助是影响照护负担的重要因素。结论应从照护者、失能老年人及家庭内外部相关因素三方面着手缓解照护者照护负担。     

国外“医养结合”照护模式介绍及经验启示

<正>"医养结合"是我国学者提出的为实现健康老龄化的新型的养老照护模式,2013年国家正式下发的《国务院关于加快发展养老服务业的若干意见》~([1]),该意见明确了积极推进医疗卫生与养老服务相结合,推动医养融合发展。2015年国务院转发的《关于推进医疗卫生与养老服务相结合的指导意见》~([2])更是对医疗卫生与养老服务结合提出了更明确的指导意见,鼓励通过建设医疗养老联合体等多种方式,整合医疗、康复、养老和护理资源,为老年人提供治疗期住院、康复期护理、稳定     

失能老年人长期照护需求及影响因素

目的了解新疆石河子市失能老年人长期照护的需求,分析其影响因素。方法采用日常生活能力(ADL)量表对石河子市老年人进行失能筛查,对符合失能标准的298名老年人采用以Maslow需求论为理论框架,自行设计的长期照护需求调查表进行问卷调查。结果石河子市失能老年人对长期照护的需求水平低,经多元线性回归分析,影响其长期照护需求的因素为失能原因和失能程度。结论以石河子市失能老年人的需求为向导,结合影响需求的因素,开展适合该人群的居家长期照护服务。     

Disability-based classification system for older people in integrated long-term care services: the Iso-SMAF profiles

This study was conducted to develop and evaluate a disability-based classification system for management of long-term care (LTC) needs in an integrated service delivery system. We collected cross-sectional data on 29 items of the Functional Autonomy Measurement System (SMAF) from a stratified multistage sampling of 1977 elderly people with disabilities living in different environments. Disability profiles were identified using statistical clustering techniques combined with advice form a panel of experts. Their clinical meaningfulness, stability, reproducibility, homogeneity, heterogeneity and predictive validity were evaluated. The Iso-SMAF classification consisted of 14 homogeneous disability profiles characterized by a gradual progression in the severity of disabilities in instrumental activities of daily living (IADL) and activities of daily living (ADL) accompanied by predominant limitations either in mobility or mental functions. The profiles achieved a Kappa reproducibility coefficient of 0.67 through cross validation. A stable cluster structure emerged when the items were analyzed using different methods. They explained 82% of the variance in nursing care time, 80% of the variance in cost of nursing care (skilled and unskilled) and 57% of the variance in total costs including both formal and informal sources of LTC services. The conclusion recommends their use for planning, managing and predicting LTC service needs in an integrated care system.     

Health care for older people in Ireland

Despite a low level of popular advocacy for older people, specialist medical and psychiatric services for older people have developed rapidly in Ireland, and geriatric medicine has become the largest medical specialty in hospital practice. Official policy has incorporated significant recognition of the special needs of older people, but implementation of these policies has been variable and inadequate. No significant transfer of funding has accompanied advances in specialist medical manpower, and there are deficiencies in the full complement of rehabilitation therapists available in the hospitals and the community. Community and long-term care services are relatively underdeveloped; it may require legislative initiatives similar to the Older Americans Act to prompt the profound improvement required in these areas.     

Posthospital care for older people: a collaborative solution

This collaborative model of "short-term, long-term care" (Brody, 1987) for older persons returning home after a hospital stay involved three hospitals, a senior center, and an Area Agency on Aging. The program provided short-term (up to 6 weeks) case management and nonmedical, supportive services to elderly individuals, in their own homes, immediately following discharge from acute-care hospitals. Client satisfaction was high, costs were moderate, and only one-third of the clients required formal services after 6 weeks. The program was discontinued due to lack of funding.